Inflatable thermal blanket with provision for being secured during use

ABSTRACT

An inflatable thermal blanket for thermal blanket and bathing a patient in a thermally-controlled inflating medium includes an inflatable thermal blanket with selectively activated ties to secure the thermal blanket to itself or hospital equipment. The inflatable thermal blanket has an outer edge and one or more substantially flat flexible flaps along the outer edge. Selected portions of the flaps include boundaries, such as perforations, defining corresponding ties. Selected ones of the ties are activated by detaching them along their respective boundaries. Then, the ties are attached to hospital equipment, or opposing ties may be attached to each other.

CROSS-REFERENCES TO RELATED APPLICATIONS

This application is continuation of U.S. Ser. No. 08/531,772, filed Sep.21, 1995 now U.S. Pat. No. 5,773,275.

This application is related to U.S. patent application Ser. No.08/419,718, filed on Apr. 10, 1995 in the name of Scott D. Augustine etal. The '718 application is a continuation of U.S. patent applicationSer. No. 07/638,748 which issued as U.S. Pat. No. 5,405,371. The '371patent is incorporated herein by reference.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention relates to inflatable thermal blankets thatregulate a patient's temperature by bathing the patient inthermally-controlled air. More particularly, the invention concerns amethod and apparatus for securing such a blanket during use.

2. Description of the Related Art

Augustine, et al. first described the use of temperature-controlled airto regulate the body temperature of patients, especially during andafter surgery. U.S. Pat. No. 4,572,188, for example, used convectivewarming to prevent or treat hypothermia. In the '188 patent,temperature-controlled air is supplied by a blower unit that isconnected to an airflow cover by a hose. In later-issued patents ownedby the assignee of this application, the term “inflatable thermalblanket”, synonymous with “airflow cover”, is introduced. See, forexample, U.S. Pat. No. 5,24,320, for “Thermal Blanket”.

Inflatable thermal blankets assume a variety of shapes and sizes forspecialized use, and include various inflatable structures that wraparound or drape over a patient. See, for example, U.S. Pat. Nos.5,300,102 and 5,336,250. The mechanism for delivering heated air to apatient has also been expanded, beyond inflatable blankets, to includeself-supporting tubes and plenums. See, for example, U.S. Pat. Nos.5,300,101 and 5,350,417.

For ease of description, the various inflatable mechanisms fordelivering a flow of temperature-controlled air to bathe a patient arereferred to herein as “inflatable thermal blankets” (or, “thermalblankets”). Patient-warming systems that use inflatable thermal blanketssuch as these may be collectively referred to as “convective warmingsystems.” The basic convective warming system includes a heater/blowerunit, an inflatable thermal blanket, and a flexible delivery hoseconnecting the two. These convective warming systems provideacknowledged clinical benefits.

Various embodiments of known inflatable thermal blankets have usedstrips of adhesive tape to prevent a blanket moving with respect to apatient. The adhesive strips man also be used to help control the flowof the thermally-controlled air, e.g. to ensure even distribution of thetemperature-controlled air, or to prevent migration of the air toward acare site. Typically, the adhesive strips adhere the thermal blanket tothe patient or to a nearby piece of equipment, such as a hospital bed oroperating table. In many such applications, adhesive strips haveperformed satisfactorily.

Nonetheless, in certain situations, patients and medical personnel alikewould benefit from a different mechanism for securing an inflatablethermal blanket. In particular, some especially cost-sensitiveapplications require a thermal blanket that can be secured in placewithout additional supplies, such as adhesive strips. Also, someapplications may necessitate a securing mechanism that does not leavesticky adhesive residue on hospital equipment, as adhesive strips can.Further, some users may desire a way to more quickly and convenientlysecure the thermal blanket.

Therefore, significant benefits would be realized with an inflatablethermal blanket that can be quickly, efficiently, and convenientlysecured in place.

SUMMARY OF THE INVENTION

Broadly, the present invention concerns an inflatable thermal blanketfor covering and bathing, a patient in thermally-controlled inflatingair, where selectively operated ties are used to secure the thermalblanket during use. The thermal blanket comprises an inflatable thermalblanket with a periphery and one or more substantially flat flexibleflaps along the periphery. In one example, the flaps may compriseportions of a peripheral seal between a base layer and an overlayinglayer.

One or more of the flaps include boundaries, such as perforations,defining ties. Selected ones of the ties are operated by detaching themfrom the thermal blanket along their respective boundaries. Then,individual ties may be tied to hospital equipment, or opposing ties maybe brought together and tied to each other, thereby securing theinflatable thermal blanket in place.

The invention affords its users with a number of distinct advantages.For example, due to the selectively detachable ties, the thermal blanketof the invention is self-restraining—the blanket can be secured in placewithout any additional materials, such as adhesive tape. By avoiding theuse of adhesive tape, the invention also avoids the damage or residuesometimes caused by adhesives. Users of the present invention will alsorecognize that the present invention is convenient, since its ties neednot be activated until the user desires. The present invention alsoprovides a number of other advantages, which are apparent from thedetailed description that follows.

BRIEF DESCRIPTION OF THE DRAWINGS

The nature, objects, and advantages of the invention will become moreapparent to those skilled in the art after considering the followingdetailed description in connection with the accompanying drawings, inwhich like reference numerals designate like parts throughout, wherein:

FIG. 1 is a perspective view of an inflatable thermal blanket pursuantto the invention, with unseparated ties;

FIG. 2 is a perspective view of the inflatable thermal blanket pursuantto the invention, with ties separated but untied;

FIG. 3 is a perspective view of an inflatable thermal blanket pursuantto the invention, with ties separated and opposing strips tied together;

FIG. 4 is a perspective view of an inflatable thermal blanket pursuantto the invention, with a first alternate embodiment of tie;

FIG. 5 is a perspective view of an inflatable thermal blanket pursuantto the invention, with a second alternate embodiment of tie; and

FIG. 6 is a perspective view of an inflatable thermal blanket pursuantto the invention, with a third alternate embodiment of tie.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS STRUCTURE

General Constructions

FIG. 1 illustrates a specific example of the present invention, in theform of an “upper body” inflatable thermal blanket 100. The thermalblanket 100 includes a first end 102, a second end 104, and a pair ofsides 106-107. The thermal blanket 100 also includes an inflating inletcuff 108, which may be connected to a tube (not shown) leading to anexternal heater/blower unit (not shown). Together, the tube andheater/blower unit provide a heated airstream to inflate the thermalblanket 100. The blower unit may comprise a machine illustrated in oneof the following U.S. patent applications, each of which is incorporatedhereby by reference: Ser. No. 08/383,880, filed on Feb. 6, 1995,entitled “Source of Inflating Medium with Active Noise Cancellation foran Inflatable Thermal Care Apparatus” in the name of Scott D. Augustine,and Ser. No. 08/242,780, filed on May 16, 1994, entitled “Low Noise AirBlower Unit” in the name of Randall C. Arnold.

The thermal blanket 100 includes an overlying layer 110 and a base layer112. The base layer 112 preferably includes an underside layer formedfrom flexible material capable of bonding to a layer of heat-sealableplastic. For instance, the base layer 112 may comprise a stratum offibrous material pre-laminated with a layer of heat-sealable plastic.

The overlying layer 110 preferably comprises a sheet of plastic heatsealed to the base layer 112 at multiple attachment points, such as theseam 114, which provide an array of multiple inflatable chambers124-131. In the preferred embodiment, the seams are selectivelyinterrupted to form passageways between adjacent chambers, such that airarriving through the cuff 108 flows into and inflates all chambers ofthe thermal blanket 100. The base layer includes a plurality of exhaustports (not shown) which open through the base layer into the inflatablechambers to exhaust thermally-controlled air from the chambers 124-131into a thermal care site (not shown) within which the patent 120 lies;.The exhaust ports may have a diameter, for example, of about {fraction(1/16)} inch.

Non-Inflated and Recessed Portions

In contrast to the inflatable chambers 124-131, the thermal blanket 100may also include a number of non-inflated or recessed portions,described as follows. For example, the thermal blanket defines a recess118 centrally positioned at the foot end 104 of the thermal blanket 100to accommodate the patient's torso. In the illustrated embodiment, therecess 118 is facilitated by truncated chambers 124 and 129. With theupper torso and arms of a patient 120 being thermally bathed, the recess118 permits observation of the patient's middle torso from almost anylocation with respect to the thermal blanket 100. The recess 118 may beprovided with a tape strip along its margin; this helps prevent loss ofthe inflating air about the patient's torso proximate the recess 118.

The thermal blanket 100 may also include a cutout area 122 centrallypositioned at the first end 102 of the thermal blanket 100. In theillustrated embodiment, the cutout area 122 is formed by truncatedchambers 127-128 and 130-131. The cutout area 122 permits observation ofthe patient's head and neck from almost any location with respect to thethermal blanket. It also assists in thermally thermal blanket thepatient's shoulders and arms without thermal blanket the patient's face.

In addition, a head drape (not shown) may be secured to the thermalblanket 100 near the cutout area 122. The head drape, which may comprisea material such as a flexible plastic, may be placed over the patient'shead to administer thermal care to the patient's face. neck, etc. One ormore vents may be provided in the head drape to assist the flow of freshinflating air past the patient's head.

Generally, the non-inflated portions of the thermal blanket 100 comprisevarious flaps and borders present along the periphery of the thermalblanket 100. In the illustrated embodiment, the thermal blanket 100includes a set of four flaps 132 a- 132 d. In one embodiment, the flaps132 a- 132 d comprise a substantially flat region formed by bonding theoverlying layer 110 and the base layer 112. Alternatively, one or theother of the overlying and base layers 110, 112 may be truncated, withthe flaps 132 a- 132 d comprising the remaining surface 110 or 112alone. The flaps 132 a- 132 b are defined with respect to each other bythe recess 118; similarly, the flaps 132 c- 132 d are defined withrespect to each other by the cutout area 122. The flaps 132 a and 132 dare positioned to oppose each other, as are the flaps 132 b and 132 c.The periphery of the thermal blanket 100 includes the side borders 134,136, which comprise bonded regions of the layers 110, 112 at opposingends of the chambers 124-131.

Retaining Strips

Refer now to FIGS. 1, 2, and 3 for an understanding of how the thermalblanket 100 is secured against movement during use. The thermal blanket100 includes ties 138 a- 138 d pre-defined in the flaps 132 a- 132 d,which secure the thermal blanket during use as described below. Each tie138 a- 138 d comprises a relatively narrow portion of a flap 132 a- 132d running parallel to an outer edge of the thermal blanket 100, asdefined by a boundary 140 a- 140 d. For example, the tie 138 a isdefined in the flap 132 a by the boundary 140 a. The boundaries 140 a-140 d preferably comprise perforated lines that are individually severedto free a corresponding tie 138 a- 138 d along a corresponding boundary140 a- 140 d. Alternatively, the boundaries 140 a- 140 d may compriseregions of the flaps 132 a- 132 d that are thinned, pre-cut and lightlyadhered, or otherwise weakened to provide ties 138 a- 138 d that areeasily freed from their respective flaps.

Each tie 138 a- 138 d has a sufficient length to reach and tie to anopposing tie. Preferably, each of the boundaries 140 a- 140 d begins atan inward position of a flap 132 a- 132 d (i.e., proximate the recess118 or cutout area 122), and extends outward a distance toward theneighboring side 106-107. In the case of the tie 138 a, for example, theboundary 140 a begins at a point 150 and extends to a point 152. Thus,when the tie 138 a is activated by tearing the boundary 140 a frombeginning 150 to end 154 as shown in FIG. 2, the activated tie 138 a islargely freed from attachment to the flap 132 a, but still integral with(or, securely attached to) the flap 138 a at a base region 154.Preferably, the base region 154 is aligned between the patient's elbowand wrist.

After the ties 138 a- 138 d are freed, opposing ties 138 a and 138 d,and opposing ties 138 b and 138 c are tied together, as shown in FIG. 3.The boundaries 140 a- 140 d are preferably defined such that each strip138 a- 138 d is sufficiently wide to avoid any peripheral nerve damageto the patient's arm should the arm fall from the operating table.

FIG. 4 illustrates an alternate embodiment of the invention whichincludes ties 400-403. Each of the ties 400-403 comprises an elasticband connected to a respective flap 132 a- 132 d by adhesive, sewing,stapling, looping through an aperture in the flap and attachment toitself, etc. In the illustrated embodiment, opposing ties are securedwith a buckle 406, which is used to selectively tighten the bands.Alternatively, opposing bands may be tied together, or secured usinganother appropriate device. As an other alternative, opposing ties (suchas 400 and 403) may comprise a single, continuous band, which can betightened as desired by operating a buckle or another appropriatedevice.

FIG. 5 illustrates another alternate embodiment of the invention whichincludes ties 500-503. Each of the ties 500-503 comprises a flexibleelastic or non-elastic strap, connected to a respective flap 132 a- 132d by adhesive, sewing, stapling, looping through an aperture in the flapand attachment to itself, etc. Unlike the embodiment of FIG. 4, however,opposing ties are secured with connectors 506-507 positioned at therespective ties' distal ends. The connectors 506-507 may comprise smalladhesive patches, snaps, claps, complementary sections of hook and eyematerial, or another suitable device for connecting the ties. To tightenthe straps, buckles (not shown) may be provided to “snug up” the straps.Alternatively, the straps may be cut with a sufficiently short lengththat joining the connectors 506-507 retains the thermal blanket 100 withsuitable tightness.

FIG. 6 illustrates still another alternate embodiment of the inventionwhich includes ties 600-603. Each of the ties 600-603 comprises anelastic or non-elastic string connected to a respective flap 132 a- 132d by adhesive, sewing, stapling, looping through an aperture in the flapand attachment to itself, etc. In this embodiment, opposing ties areconnected by tying them into a knot. Alternatively, opposing ties may beconnected by devices as described above, e.g. buckles, small adhesivestrips, snaps, claps, complementary sections of velcro, etc.

Operation

The thermal blanket 100 may be positioned by disposing the inflatablechambers transversely across the patient's upper torso and arms so as tothermally control those areas while advantageously leaving the patient'slower torso exposed for access by medical personnel. The thermal blanket100 may be used alone or in combination with a “lower body” inflatablethermal blanket, depending on the location of the care site. Thus,various selected portions of the patient may be selectively treated withthe illustrated thermal blankets while care and treatment are renderedto other areas.

Referring to FIG. 1, the thermal blanket 100 is operated by firstplacing the thermal blanket 100 over the patient 120. In the illustratedembodiment, the patient 120 is in a supine position, resting upon acruciate operating table 142. The patient's torso is aligned with acentral bed portion 144 of the table 142, and the patient's arms areextended along arm boards 146-147 of the table 142. Thus, the thermalblanket 100 is positioned transversely across the patient's upper body.The bibs and drape, where applicable, are laid out over the patient asnecessary.

Then, in the embodiment of FIGS. 2-3, selected ones of the ties 138 a-138 d are activated by detaching them along, their respective boundaries140 a- 140 d, as shown in FIG. 2. Each tie is tied as desired. Asillustrated by the example of FIG. 3, the ties 138 a- 138 b may be tiedto opposing, ties 138 d- 138 c (respectively). With this arrangement,each pair of opposing ties is tied about an arm board 146-147 of theoperating table 142. This not only holds the thermal blanket 100 inplace, but also helps retain the thermally-controlled inflating airabout the patient's arms. Alternatively, the ties 138 a- 138 d may betied to hospital equipment such as the operating table, for example.

Next, a blower unit (not shown) is coupled to the cuff 108, and anappropriate temperature is selected using the blower unit. When theblower unit is activated, temperature-controlled air is injected intothe chambers 124-131, inflating the thermal blanket 100. In the case ofa hypothermic patient 120, the air preferably comprises warmed air. Thechambers 124-131 exhaust the air through the exhaust ports of the baselayer 112, thereby enveloping the desired regions of the patient 120 ina bath of the thermally-controlled air.

As a final measure, if desired, a conventional fabric blanket may beplaced over the thermal blanket 110. During operation, the patient'stemperature should be monitored regularly and the temperature setting ofthe blower unit adjusted accordingly.

Other Embodiments

While there have been shown what are presently considered to bepreferred embodiments of the invention, it will be apparent to thoseskilled in the art that various chances and modifications can be madeherein without departing from the scope of the invention as defined bythe appended claims.

For example, although specific references are made to the use of “air,”this is merely provided for an exemplary description of an inflatingmedium. Moreover, ordinarily skilled artisans will recognize that,instead of heating the inflating medium, it may be cooled to treatfebrile patients, for instance.

Additionally, the retaining strips of the invention may be implementedin a variety of inflatable thermal blankets in addition to the upperbody thermal blanket described herein. To those persons ordinarilyskilled in the art with the benefit of this disclosure, for example, itwill be apparent that the retaining strips of the invention may beimplemented in the inflatable thermal blankets described in thefollowing patents and patent applications, assigned to the assignee ofthe present application and incorporated herein by reference:

1. U.S. patent application Ser. No. 08/419,719, filed Apr. 10, 1995,entitled “Thermal Blanket”, in the names of Scott D. Augustine et al.

2. U.S. patent application Ser. No. 08/315,960, filed on Sep. 30, 1994,entitled “Convertible Thermal Blanket”, in the name of Scott D.Augustine.

3. U.S. Pat. No. 5,300,102, issued on Apr. 5, 1994, in the names ofScott D. Augustine et al.

4. U.S. Pat. No. 5,184,612, issued on Feb. 9, 1993, in the name of ScottD. Augustine.

5. U.S. Pat. No. 4,572,188, issued on Feb. 25, 1986, in the names ofScott D. Augustine et al.

6. U.S. Pat. No. 5,184,612, issued on Feb. 9, 1993, in the name of ScottD. Augustine (Ser. No. 890,554).

7. U.S. Pat. No. 5,324,320, issued on Jun. 28, 1994, in the names ofScott D. Augustine et al. (Ser. No. 703,592).

8. U.S. Pat. No. 5,336,250, issued on Aug. 9, 1994, in the name of ScottD. Augustine (Ser. No. 014,619).

9. U.S. Pat. No. 5,350,417, issued on Sep. 27, 1994, in the name ofScott D. Augustine (Ser. No. 063,214).

10. U.S. patent application Ser. No. 08/386,989, filed on Feb. 6, 1995,entitled “Patient Warming System with User-Configurable Access Panel.”in the name of Scott D. Augustine.

11. U.S. Pat. No. 5,300,101, issued on Apr. 5, 1994.

What is claimed is:
 1. An inflatable apparatus for covering and bathinga patient in a thermally-controlled inflating medium, comprising: aninflatable apparatus, including: a flexible base sheet including aplurality of exhaust ports; and a flexible overlaying sheet attached tothe base sheet to define multiple inflatable chambers between the basesheet and the overlaying sheet; said inflatable apparatus having aperiphery and at least one substantially flat flexible non-inflatableflap along the periphery, a portion of said at least one flap includinga boundary defining a corresponding tie for being separated from theflap by detachment along the boundary; and an inflating inlet in aircommunication with the inflatable chambers.
 2. The apparatus of claim 1,wherein said flap comprises a substantially flat peripheral sealcircumscribing coincident outer edges of the overlaying sheet and thebase sheet.
 3. The apparatus of claim 1, wherein the flap comprises anouter edge of the overlaying sheet.
 4. The apparatus of claim 1, whereinthe flap comprises an outer edge of the base sheet.
 5. The apparatus ofclaim 1, wherein the boundary comprises a perforated line.
 6. Theapparatus of claim 1, wherein the boundary comprises a lightly adheredjunction.
 7. The apparatus of claim 1, wherein the boundary comprises athinned region.
 8. The apparatus of claim 1, wherein said inflatablechambers include elongated tube-shaped chambers.
 9. The cover of claim1, wherein the cover is substantially rectangular and the peripherydefines a recess and an opposing cutout area, the periphery comprisingtwo pairs of opposing substantially flat flexible non-inflatable flaps,each including a tie.
 10. The apparatus of claim 9, including a pair ofboundaries initiating at the recess and extending a first distanceoutward substantially along the periphery, and a pair of boundariesinitiating at the cutout and extending a second distance outwardsubstantially along the periphery.
 11. The apparatus of claim 10,wherein the first and second distance are substantially equal.
 12. Aninflatable apparatus for covering and bathing a patient in athermally-controlled inflating medium, comprising: an inflatableapparatus, including: a flexible base sheet with a plurality of exhaustports; and a flexible overlaying sheet attached to the base sheet atmultiple attachment points defining multiple inflatable chambers betweenthe base sheet and the overlaying sheet; said inflatable apparatushaving a periphery with opposing uninflatable flaps and opposing ends;multiple ties disposed at separate positions in the uninflatable flapsto secure the apparatus in place; and an inflating inlet incommunication with the inflatable chambers.
 13. The apparatus of claim12, wherein the ties comprise elastic bands.
 14. The apparatus of claim12, wherein the ties comprise strings.
 15. The apparatus of claim 12,wherein the ties comprise flexible straps having distal ends affixed toconnectors.
 16. The apparatus of claim 15, wherein the connectorscomprise selected patterns of hook and eye material.
 17. The apparatusof claim 15, wherein the connectors comprise adhesive patches.
 18. Amethod of operating an inflatable apparatus to cover and bathe a patientin a thermally-controlled inflating medium, wherein the inflatableapparatus comprises multiple interconnected inflatable chambers, aperiphery and flexible uninflatable flaps along the periphery, whereinselected portions of said flaps include boundaries definingcorresponding ties, said method comprising the steps of: placing theinflatable apparatus over a patient; freeing a pair of opposing ties bydetaching the ties from the uninflatable flaps along respectiveboundaries, the ties remaining attached to the inflatable apparatus atrespective tie ends; coupling the pair of opposing ties together; anddirecting a stream of inflating medium into the inflatable chambers toinflate the apparatus.
 19. The method of claim 18, wherein the patientis lying upon a central bed portion of a cruciate table and thepatient's arms are extended along lateral arm boards of the table, andwherein the coupling step comprises the steps of bringing togetheropposing ties about an arm board and tying the opposing ties together.20. The method of claim 18, wherein the directing step is performedafter the coupling step.
 21. The method of claim 18, wherein thedirecting step is performed before the coupling step.
 22. The method ofclaim 18, wherein the boundaries comprise perforations and the freeingstep comprises a step of severing selected perforated regions.
 23. Amethod of operating an inflatable apparatus to cover and bathe a patientin a thermally-controlled inflating medium, wherein the apparatusincludes multiple interconnected inflatable chambers and a periphery,wherein the apparatus further includes opposing uninflatable flaps atsaid periphery which include boundaries defining corresponding ties,said method comprising the steps of: placing the inflatable apparatusover a patient; freeing a tie from within an uninflatable flap bydetaching the tie along a boundary thereof, the tie remaining attachedto the inflatable apparatus at a tie end in the uninflatable flap;securing the tie to a fixed object separate from the apparatus; anddirecting a stream of inflating medium into the inflatable chambers toinflate the apparatus.
 24. The method of claim 23, wherein the directingstep is performed after the securing step.
 25. The method of claim 23,wherein the directing step is performed before the securing step. 26.The method of claim 23, wherein the boundaries comprise perforations andthe freeing step comprises a step of severing along the perforations.27. The method of claim 23, wherein the fixed object comprises ahospital operating table.
 28. The method of claim 23, wherein the fixedobject comprises a hospital bed.
 29. A method of operating an inflatableapparatus to cover and bathe a patient in a thermally-controlledinflating medium, wherein the apparatus comprises multipleinterconnected inflatable chambers to receive the inflating air andexpel the air through a plurality of exhaust ports defined in a commonsurface of the chambers, said apparatus having a pair of opposing outeruninflatable flaps each including multiple ties, said method comprisingthe steps of: arranging a patient upon a cruciate operating table witheach of the patient's arms extended laterally; placing the inflatableapparatus over a patient's upper body in a transverse position such thatthe apparatus extends from one arm, across the upper body, and acrossthe other arm; securing the apparatus in place around a first arm byconnecting ties of opposing uninflatable flaps to form a loop about saidfirst arm; securing the apparatus in place around a second arm byconnecting opposing ties to form a loop about said second arm; anddirecting a stream of inflating medium into the inflatable chambers toinflate the apparatus and bathe the patient in the thermally-treatedinflating air.
 30. The method of claim 29, wherein the ties compriseelastic bands and each securing step comprises the steps of placing theelastic bands around the patient's extended arms.
 31. The method ofclaim 29, wherein the ties comprise strings and each securing stepcomprises the steps of placing opposing strings around the patient'sextended arms and tying the opposing strings together.
 32. The method ofclaim 29, wherein the ties comprise flexible straps having distal endsaffixed to connectors, and each securing step comprises the steps ofplacing opposing straps around the patient's extended arms and attachingconnectors of opposing straps.
 33. The method of claim 32, wherein theconnectors comprise selected patterns of hook and eye material, and theattaching steps comprise the steps of pressing the connectors ofopposing straps together.
 34. The method of claim 32, wherein theconnectors comprise adhesive patches, and the attaching steps comprisethe steps of pressing the connectors of opposing straps together. 35.The method of claim 29, wherein the directing step is performed afterthe securing steps.
 36. The method of claim 29, wherein the directingstep is performed before the securing steps.